Extraperitoneal colostomy reduces complications after laparoscopic APR

A systematic review involving 1,002 patients revealed that extraperitoneal colostomy (EPC) significantly lowers the incidence of parastomal hernia compared to transperitoneal colostomy (TPC) after laparoscopic abdominoperineal resection for rectal cancer. The EPC technique also showed reduced rates of stoma retraction, prolapse, and overall stoma-related complications. Importantly, both approaches did not differ significantly in total operative time or colostomy creation duration, suggesting EPC may be a safer option for long-term colostomy care.